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Volume 25 (4)

Volume 25, Issue 4, Fall 2005line
J Contin Educ Health Prof 2005; 25(4):248
ORIGINAL ARTICLE

Design and Implementation of Training to Improve Management of Pediatric Overweight
Luke Beno, MD
Josephine Hinchman, MPH
Debra Kibbe, MS
Frederick Trowbridge, MD, MSc

A b s t r a c t

Introduction: Clinicians report a low proficiency in treating overweight children and using behavioral management strategies. This paper documents the design and implementation of a training program to improve clinicians' skills in the assessment and behavioral management of pediatric overweight.
Methods: Two one-hour CME trainings were designed using published guidelines, research findings, and expert committee recommendations. The trainings were provided to clinicians of a managed care pediatric department, utilizing novel screening and counseling tools, and interactive exercises. Surveys and focus groups were conducted 3 and 6 months post intervention to examine clinician attitudes and practices regarding the screening and counseling tools.
Results: Post intervention, the majority of clinicians agreed that the clinical practice guidelines (Pediatric Obesity Practice Resource) and BMI-for-age percentile provided useful information for clinical practice. Clinicians reported an increased utilization of the recommended screening tools and changes in office practices to implement these tools. They offered suggestions to improve the ease of use of the tools and to overcome perceived clinician and/or patient barriers.
Discussion: A brief, cost effective, multi-faceted training and provision of counseling tools were perceived as helpful to clinical practice. Useful lessons were learned about tool design and ways to fit tools into practice. Training the entire health care team is advantageous to the adoption of new tools and practices.

Lessons for Practice
  • Training of pediatric health care teams in the assessment and management of pediatric overweight can result in positive attitudes and improved self-efficacy in clinicians
  • Skill building, as opposed to didactic training, is likely to be the most effective teaching strategy
  • Inclusion of the entire medical team helps create a positive environment that supports the behavioral management efforts of clinicians
  • Learner fatigue may occur if too many tools are presented at one time. In addition, limited tool use may result if practical application in the clinical setting is not feasible or if sufficient "practice time" is not available to allow clinicians to become familiar with their use


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